Provider Demographics
NPI:1699292359
Name:ERNST, PHILLIP (PA-C)
Entity type:Individual
Prefix:MR
First Name:PHILLIP
Middle Name:
Last Name:ERNST
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 ALPINE DR
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47006-8477
Mailing Address - Country:US
Mailing Address - Phone:812-932-3224
Mailing Address - Fax:812-932-3229
Practice Address - Street 1:620 RING RD
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:OH
Practice Address - Zip Code:45030-2740
Practice Address - Country:US
Practice Address - Phone:812-932-3224
Practice Address - Fax:812-932-3229
Is Sole Proprietor?:No
Enumeration Date:2017-08-24
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant